Provider Demographics
NPI:1699076448
Name:GENE W. SCHEEL DMD PS
Entity type:Organization
Organization Name:GENE W. SCHEEL DMD PS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:GENE
Authorized Official - Middle Name:WAYNE
Authorized Official - Last Name:SCHEEL
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:360-896-5150
Mailing Address - Street 1:11818 SE MILL PLAIN BLVD
Mailing Address - Street 2:SUITE 106
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98684-5089
Mailing Address - Country:US
Mailing Address - Phone:360-896-5150
Mailing Address - Fax:360-896-0253
Practice Address - Street 1:11818 SE MILL PLAIN BLVD
Practice Address - Street 2:SUITE 106
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98684-5089
Practice Address - Country:US
Practice Address - Phone:360-896-5150
Practice Address - Fax:360-896-0253
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-10
Last Update Date:2010-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE00007282122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty